<p>Your Name*<br />
    [text* your-name] </p>
<p>Your Email*<br />
    [email* your-email] </p>
<p>Your Phone<br />
    [text Phone:]

[checkbox checkbox-547 label_first use_label_element exclusive "Allow text messages from SJVC:  yes"]

<p>Select A Campus<br />
    [select Campus multiple "--Select One--" "Fresno " "Bakersfield " "Visalia" "Modesto" "Hanford" "Hesperia" "Lancaster" "Rancho Cordova" "Rancho Cucamonga" "Temecula" "San Diego" "SJVC Online"]  

<p>Select A Course<br />
 [select newmenu multiple "--Select One--" "Business Courses:" "Medical Biller or Coder              " "Business Administrative Assistant" "Correctional Officer" "" "Medical Courses:" "Medical Assistant" "Dental Assistant" "Pharmacy Technician" "Respiratory Therapist" "Massage Therapist" "" "Technical Courses:" "HVAC Technician" "Computer Support Technician" "Maintenance/ Mechanical Technician" "Aviation (A&P) Mechanic"]  

<p>Your Message<br />
    [textarea textarea-292] </p>

[submit "Request Information"]
[your-subject]
[your-name] <[your-email]>
From: [your-name] <[your-email]>
[Phone:]
[text Phone:]
[Campus]
[Course]
Subject: [your-subject]

Message Body:
[textarea-292]


Lead Generation form San Joaquin Valley College https://new1.sjvc.edu
curtis.lipsey@sjvc.edu




[your-subject]
[your-name] <[your-email]>
Message body:
[your-message]

--
This mail is sent via contact form on San Joaquin Valley College https://new1.sjvc.edu
[your-email]



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